| NPI | 1689802647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA09182700) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 125057163) |
| 207N00000X Dermatology (Licence: NY 266015) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2013-09-25 |