| 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 (Licence: NY 06651) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2022-05-02 |