| NPI | 1609082924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 004781) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ md002572) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |