| NPI | 1407475759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 336553) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA12307900) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2025-09-16 |