| NPI | 1134127632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N005747) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00268700) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2016-09-21 |