| NPI | 1801116389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NJ 25MA09704600) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA09704600) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 273743-1) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2016-08-26 |