| NPI | 1831116607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: NJ 25MD00182700) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ MD001827) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2008-02-05 |