| NPI | 1720282163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 233098-01) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 57.009255) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-10-20 |