| NPI | 1912067836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA10827300) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD440212) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-11-04 |