| NPI | 1366908139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY N004198) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 1000889) |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |