| NPI | 1942209028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25ma05994500) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA05994500) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2025-08-25 |