| NPI | 1164424859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CT 000626) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005083) |
| 213ES0131X (Licence: CT 000626) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2015-03-24 |