| NPI | 1083676258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: NY n005888) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005888) |
| 213ES0131X (Licence: NJ 25MD00287400) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2025-04-02 |