| NPI | 1891059887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA 001267) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NV 2126) |
| 213ES0131X (Licence: GA 001267) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2026-03-11 |