| NPI | 1740285097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 190994-1) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 034517) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2024-03-12 |