| NPI | 1922454131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: LA 333207) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 213E00000X Podiatrist (Licence: IL 016005825) | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2022-12-02 |