| NPI | 1720091200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 248093-1) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD.200357) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2008-05-06 |