| NPI | 1285845941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA09201200) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 245009) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NY 245009) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-03-13 |