| NPI | 1922569821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 692023) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00366300) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2023-09-28 |