| NPI | 1013577717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 692150) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N007291) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2024-07-25 |