| NPI | 1962296830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 0000000000) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 0000000000) |
| 213ES0131X (Licence: MI 0000000000) | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |