| NPI | 1205849395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA12458200) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 156839) |
| 207N00000X Dermatology (Licence: PA MD487467) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2025-03-03 |