| NPI | 1306827324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A100588) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 230156-1) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-03-21 |