| NPI | 1619950565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 1646) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: TX 1646) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NY N005645) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2014-08-11 |