| NPI | 1164861282 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 269742) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 256981) | 
| Enumeration Date | 2013-06-21 | 
| Last Update Date | 2022-07-21 |