| NPI | 1154569275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 261157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10031166) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2013-07-12 |