| NPI | 1104906908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D0061483) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD034830) |
| 207N00000X Dermatology (Licence: VA 0101236289) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2014-05-29 |