| NPI | 1871560268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY NY165531) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: NY 165531) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: NY 165531) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 165531) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NY 165531) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2007-07-08 |