| NPI | 1063572907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VT 042-0011829) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD436030) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-09-22 |