| NPI | 1760124358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM T-22102) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM T22102) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2024-09-14 |