| NPI | 1003974684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY N004506) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N004506) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-10-10 |