| NPI | 1194801506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 008089-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008089) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-27 |