| NPI | 1679789192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E5885) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 15478) |
| 213E00000X Podiatrist (Licence: CT 1038) | |
| 213E00000X Podiatrist (Licence: NY 007058) | |
| 363A00000X Physician Assistant (Licence: CT 4656) | |
| 363A00000X Physician Assistant (Licence: NY 011385) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2024-05-22 |