| NPI | 1073802450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 260162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 260162) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2021-08-25 |