NPI | 1053353680 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA06220100) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ MA62201) |
Enumeration Date | 2006-06-11 |
Last Update Date | 2013-02-18 |