| NPI | 1003951187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: NY N005855) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY N005855) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2012-07-11 |