| NPI | 1730476649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO3907) |
| Additional Taxonomies | 213EP0504X Podiatrist Public Medicine (Licence: FL PO3907) |
| 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: FL PO3097) | |
| 213ER0200X Podiatrist Radiology (Licence: FL PO3907) | |
| 213ES0000X Podiatrist Sports Medicine (Licence: FL PO3907) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO3907) | |
| 213ES0131X Podiatrist Foot Surgery (Licence: FL PO3907) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-07-21 |