| NPI | 1972596831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ 630) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: AZ 0630) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2010-06-28 |