| NPI | 1275568495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35-084878) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: OH 35-084878) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2010-08-23 |