NPI | 1508427980 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VT 061.0000031) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY P102851) |
Enumeration Date | 2019-06-26 |
Last Update Date | 2020-08-04 |