| NPI | 1760943419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N007206) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NY N007206) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2022-09-20 |