| NPI | 1578682985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 228668) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 228668) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NY 228668) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-09-11 |