| 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 | 2025-09-02 |