| NPI | 1902827496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CT 000304) |
| Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: CT 000304) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: CT 000304) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2011-12-23 |