| NPI | 1235351065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX F-1433) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX F-1433) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-08-15 |