| NPI | 1962454017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016004478) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 835025) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-06-23 |