| NPI | 1417034232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: NY 006189) |
| Additional Taxonomies | 213EP0504X Podiatrist, Public Medicine (Licence: NY 006189) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY 006189) | |
| 213ER0200X Podiatrist, Radiology (Licence: NY 006189) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: NY 006189) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2015-01-14 |