| NPI | 1952612558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IA 000870) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: PA SC006235) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2018-09-14 |