| NPI | 1760719967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA09262600) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 260007) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2013-05-31 |