| NPI | 1710293428 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO 3443) | 
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO 3443) | 
| 213ES0131X (Licence: FL PO 3443) | |
| Enumeration Date | 2010-08-19 | 
| Last Update Date | 2010-08-19 |