| NPI | 1699207282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001402A) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 0) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2022-09-21 |