| NPI | 1023454618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00332300) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY 006794) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2021-02-09 |