| NPI | 1891159422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO4053) |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2019-04-15 |