| NPI | 1245469196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 004831) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 2117) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2021-07-12 |