| NPI | 1821149451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00289000) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00289000) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2014-06-05 |