| NPI | 1710970108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY NY0046741) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: NY NY004674-1) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-08 |