| NPI | 1437301645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME141943) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 251813) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2020-01-08 |