| NPI | 1588757165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ MA56331) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD042661L) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-09 |