| NPI | 1043890775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA12744700) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NJ 25MA12744700) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-07-04 |