| NPI | 1265877161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 133412) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA10152800) |
| 207N00000X Dermatology (Licence: NY 291811) | |
| 207N00000X Dermatology (Licence: MD D0085560) | |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2022-05-16 |