| NPI | 1104288141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00367000) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 20200022867) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 1042) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2025-07-24 |