| NPI | 1043344112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS10899) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 236267) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-07-25 |