| NPI | 1245452796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 107793) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2006-01730) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-02-11 |