| NPI | 1699071159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 009388) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 009388) |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: NY 009388) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2017-03-02 |