| NPI | 1770830218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MN 934) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 1145-25) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 934) | |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2022-05-11 |