| NPI | 1427053776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 041257) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 198757-1) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2019-05-23 |