| NPI | 1700266509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WA PO61001004) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: GA POD001369) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-09-09 |