| NPI | 1134253552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 021353) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: GA 021353) |
| 207ZD0900X Pathology Dermatopathology (Licence: GA 021353) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: GA 021353) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2011-05-04 |