| NPI | 1962848531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R0987) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 268874) |
| 207Q00000X Family Medicine (Licence: NY 268874) | |
| 207N00000X Dermatology (Licence: NJ 25MB09831400) | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2019-09-11 |