| NPI | 1629573076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NY 007174) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NY 007174-01) |
| 213ES0131X Podiatrist Foot Surgery (Licence: NY 007174) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-05-07 |