| NPI | 1265509111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 286874) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 20A7655) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-05-18 |