| NPI | 1083021141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 006836) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY 006836) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 274346-231) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2022-11-24 |