| NPI | 1992945885 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E 4808)  | 
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E 4808)  | 
| Enumeration Date | 2009-03-05 | 
| Last Update Date | 2010-08-09 |