| NPI | 1033112248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N003940) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY N003940) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NY N003940) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NJ 25MD00276700) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2013-03-18 |