| NPI | 1780789651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 157066) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 157066-1) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2014-10-21 |