| NPI | 1114087079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 200300420) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NC 200300420) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-07-09 |