| NPI | 1881076065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: IN 07001292A) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003895) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 135000876) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2023-12-06 |