| NPI | 1487947537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 193400000X Single Specialty (Licence: NY 006495) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00307800) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2018-05-07 |