| NPI | 1124014246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 059398) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 237350) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2009-07-13 |