| NPI | 1396845798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 114927) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 114927) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-10-01 |