| NPI | 1972567550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 198125) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 1981251) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2015-03-06 |