| NPI | 1669460416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 145645) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 145645) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2007-07-08 |