| NPI | 1891006235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901002578) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO3527) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3527) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002578) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2015-06-23 |