| NPI | 1093207995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N007205-01) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5951001049) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-11-22 |