| NPI | 1942867221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO61282105) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX T23-2019) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2025-05-08 |