| NPI | 1700980893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NC 633) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH OH 3122) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2017-03-29 |