| NPI | 1821029000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WV 00356) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: WV 00356) |
| 213ES0131X (Licence: WV 00356) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-10-30 |