| NPI | 1578568887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 140666) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA03729600) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2010-11-24 |