| NPI | 1558795757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY R80330) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NY R80330) |
| 213ER0200X Podiatrist Radiology (Licence: NY R80330) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NY R80330) | |
| 213ES0131X Podiatrist Foot Surgery (Licence: NY R80330) | |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2021-12-02 |