| NPI | 1063671311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 101250252) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 259376) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2024-03-07 |