| NPI | 1578974655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N0006812-1) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 003307) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-09-01 |