| NPI | 1790779858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MS 80114) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MS 80114) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2023-01-13 |