| NPI | 1982014924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MB10251100) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA OT015927) |
| 207R00000X Internal Medicine (Licence: PA OT015927) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2018-07-27 |