| NPI | 1780977868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO 0000740) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WY 151) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2020-06-12 |