| NPI | 1174594279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 035895) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI MD10187) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2011-04-28 |