| NPI | 1093793416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: GA 60105) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 60105) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2014-10-16 |