| NPI | 1861415366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00274600) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00274600) |
| 213E00000X Podiatrist (Licence: PA SC004754L) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NJ 25MD00274600) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2022-03-01 |