| NPI | 1922256411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 111867) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 254065-1) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2020-06-22 |