| NPI | 1780147835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00370200) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00370200) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2024-04-01 |