| NPI | 1194907741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MT 49736) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 54162) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2020-07-27 |