| NPI | 1700867785 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E5292) | 
| Additional Taxonomies | 213E00000X Podiatrist (Licence: LA PD0114) | 
| Enumeration Date | 2005-11-08 | 
| Last Update Date | 2022-08-08 |