| NPI | 1770238529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 349054) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 349054) |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2022-02-18 |