| NPI | 1770565699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: AL AL164) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: GA 714) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-03-28 |