| NPI | 1164657391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2020-03326) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD041179) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2021-06-21 |