| NPI | 1821032269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 1875) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: LA DPM.PD286R) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-09-25 |