| NPI | 1306059217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 233909) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 233722) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-01-17 |