| NPI | 1710547732 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 3155) | 
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA EL6928) | 
| Enumeration Date | 2019-06-20 | 
| Last Update Date | 2022-06-14 |