| NPI | 1275731010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 193200000X Multi-Specialty (Licence: MO 2011006615) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2011006615) |
| 193200000X Multi-Specialty (Licence: KS 94-06648) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2016-05-31 |