| NPI | 1700313251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 2025025188) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006843) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2025-09-04 |