| NPI | 1023429396 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 38604)  | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.134863)  | 
| Enumeration Date | 2014-05-08 | 
| Last Update Date | 2024-02-01 |