| NPI | 1679914436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: DC PO1000112) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 36.003785) |
| 213E00000X Podiatrist (Licence: NY 8773747262) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2020-01-27 |