| NPI | 1619172541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 250652) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA08947400) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2011-07-08 |