| NPI | 1952924839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 345668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 345668) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2023-04-14 |