| NPI | 1750490553 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: OR DP223397) | 
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005845) | 
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NV 0602) | |
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2025-09-25 |