| NPI | 1134563885 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N006562) | 
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 000873) | 
| Enumeration Date | 2013-04-24 | 
| Last Update Date | 2014-05-16 |