| NPI | 1033104369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 9900350) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: NC 9900350) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2014-09-03 |