| NPI | 1487675104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N006076-1) |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: NY N006076-01) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NY N006076-1) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-10-10 |