| NPI | 1982986634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MB09569900) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: NJ 25MB09569900) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2022-09-09 |