| NPI | 1679722912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: SC 612) |
| Additional Taxonomies | 213ES0131X (Licence: SC 612) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: SC 612) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2011-09-02 |