NPI | 1992101075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: GA POD001467) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY 06651) |
213ES0131X Podiatrist, Foot Surgery (Licence: NY 06651) | |
Enumeration Date | 2014-11-17 |
Last Update Date | 2022-05-02 |