| NPI | 1285616516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PR 6418) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: PR 6418) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: PR 6418) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2014-06-05 |