| NPI | 1992742217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 244852) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 244852) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-03-09 |