| NPI | 1316933740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 2021741) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: NY 202174) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2015-04-24 |