| NPI | 1023313848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VT 056-0000182) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY 6420) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-10-07 |