| NPI | 1457766495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 006865) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: PA SC0065444) |
| Enumeration Date | 2014-06-28 |
| Last Update Date | 2019-01-08 |