| NPI | 1811930837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 005030-1) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 555) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-08-31 |