| NPI | 1205046984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME105266) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: FL ME105266) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2009-08-13 |