| NPI | 1104877893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: OH 35070289) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35070289) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-02-15 |