| NPI | 1588631816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NY N005792) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: NY N005792) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2015-12-14 |