| NPI | 1720241821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KS 12-00372) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 951) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2013-02-01 |