| NPI | 1457324493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY noo4864) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY noo4864) |
| 213ES0131X (Licence: NY noo4864) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2021-06-02 |