| NPI | 1528459484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NM POD2024-0011) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO4040) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY P96086) | |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2024-09-25 |