NPI | 1275824971 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NJ 25MD00308000) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3564) |
Enumeration Date | 2011-04-28 |
Last Update Date | 2016-12-14 |