| NPI | 1801996848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3455) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT20468) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1966) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2013-06-14 |