| NPI | 1710175997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: WI 964) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016005341) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WI 964-025) | |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2015-06-04 |