| NPI | 1467895011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA11091500) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 304242) |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2021-12-03 |