| NPI | 1730187543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 192475) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 192475) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 192475) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2009-05-13 |