| NPI | 1104872225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00333900) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005951 1) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-07-27 |