| NPI | 1043429525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2015-01774) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: SC 30884) |
| 207N00000X Dermatology (Licence: CA 116681) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-09-03 |