| NPI | 1679572978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 225963) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 225963) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2013-03-27 |