| NPI | 1699732461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WI 774-025) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 774-025) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-02-01 |