| NPI | 1154610889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 278906) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA 454292) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2019-09-16 |