| NPI | 1013960319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35067749) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: OH 35067749) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-12-17 |