| NPI | 1295364404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103301391) | 
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103301391) | 
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 007308) | |
| Enumeration Date | 2020-04-08 | 
| Last Update Date | 2024-05-15 |