| NPI | 1417919051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA28170) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 0993041) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2010-07-07 |