| NPI | 1174608137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN MD0000015766) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: TN MD0000015766) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2019-01-22 |