| NPI | 1962933812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 295017) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA11210500) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-08-30 |