| 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 |