| NPI | 1003074055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 006345) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY 006345) |
| 213ES0000X Podiatrist, Sports Medicine (Licence: NY 006345) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2010-02-09 |