| NPI | 1649632456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 310608-1) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT213320) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-01-06 |