| NPI | 1598961013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NJ 25MA08407300) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 243859) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2015-02-06 |