| NPI | 1710901145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO1675) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: FL po 0001675) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-03-06 |