| NPI | 1114976610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NM MD2012-0043) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA07980200) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-03-13 |