| NPI | 1811158298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA08981800) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT192766) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2012-02-01 |