| NPI | 1891887543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 161216) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA04075800) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-05-28 |