| NPI | 1205830106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX D9447) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX D9447) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2008-02-07 |