| NPI | 1952398869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ 292) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: AZ 0292) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: AZ 0292) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2008-09-03 |