| NPI | 1982043295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: OH 36003809) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: MA 1296) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2022-07-21 |