| NPI | 1053666370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS17445) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 20A15550) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2021-05-21 |