| NPI | 1093794117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 101139) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NM MD2017-0772) |
| 207N00000X Dermatology (Licence: NJ 25MA06877100) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-08-11 |