| NPI | 1194717447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G183935) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX S2739) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2023-03-24 |