| NPI | 1376040584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 1020578) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 316833) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2024-07-31 |