| NPI | 1467561613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 253337) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: UT 372740-1205) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-09-19 |