| NPI | 1780603902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00266300) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC005550) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-02-19 |