| NPI | 1245349190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR 182101) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 0000049928) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-03-17 |