| NPI | 1588783708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N005036) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 001825) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2012-06-07 |