| NPI | 1275612319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101244058) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A94851) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2018-12-04 |