| NPI | 1295969624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 269568) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 269568-1) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2025-06-23 |