| NPI | 1215340450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 295403) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OR MD209281) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-06-18 |