| NPI | 1245495365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0071050) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 263711) |
| 207Q00000X Family Medicine (Licence: NY 263711) | |
| 207Q00000X Family Medicine (Licence: MD D0071050) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA08428600) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2020-02-12 |