| NPI | 1891996302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 249120) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME98380) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-12-28 |