| NPI | 1598723884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA05943700) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA059437) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-07-23 |