| NPI | 1710912209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: NY n005994-1) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005994) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N005994-1) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-02-06 |