| NPI | 1528067683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 301241) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA C159568) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2024-01-15 |