| NPI | 1982196416 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 3102)  | 
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 3102)  | 
| Enumeration Date | 2018-05-31 | 
| Last Update Date | 2025-03-03 |