| NPI | 1407962764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CT 044445) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 240336) |
| 207N00000X Dermatology (Licence: CT 044445) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-03-19 |