| NPI | 1902049307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 2007022634) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2007022634) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2016-12-18 |