NPI | 1760124358 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM T22102) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM Resident) |
Enumeration Date | 2022-04-13 |
Last Update Date | 2023-11-09 |