| NPI | 1477552891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25md00276100) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY 65005828) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NJ 25md00276100) | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY 65005828) | |
| 213ES0131X (Licence: NJ 25md00276100) | |
| 213ES0131X (Licence: NY 65005828) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2011-11-07 |