| NPI | 1225102452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 20817) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA 03200) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2024-07-15 |