| NPI | 1861512618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901001082) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: MI KD1082) |
| 213ES0131X Podiatrist Foot Surgery (Licence: MI KD1082) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-09-29 |