| NPI | 1922018522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO2134) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MN 580) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-08-01 |