| NPI | 1770704363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: GA POD001107) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5901002168) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-03-22 |