| NPI | 1124021035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G48190) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA GR0045780) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2023-03-24 |