| NPI | 1629323175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NC 655) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 655) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 65P84883) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NC 655) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2023-02-22 |