| NPI | 1760700942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL 161615) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 310675) |
| 207N00000X Dermatology (Licence: CA A114925) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 310675) | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2023-06-29 |