| NPI | 1972587178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103000870) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 1119) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2015-08-12 |