| NPI | 1891956595 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD446369)  | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA09329100)  | 
| Enumeration Date | 2008-06-24 | 
| Last Update Date | 2013-07-02 |