| NPI | 1598027906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 288859) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 288859) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD467931) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2024-08-09 |