| NPI | 1417229683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA09642300) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 278563) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2019-04-18 |