| NPI | 1194069336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PR 18762) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: PR 27279) |
| Enumeration Date | 2012-11-10 |
| Last Update Date | 2022-07-21 |