| NPI | 1164665659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 39015) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101253913) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2021-05-07 |