| NPI | 1780014571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MP00327900) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00327900) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2022-11-11 |