| NPI | 1255628889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 006527) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00322200) |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2020-11-15 |