| NPI | 1760479174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 835) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: TX 1249) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-07-20 |