| NPI | 1972854958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3559) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO 3559) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2019-09-13 |