| NPI | 1285622852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME106898) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D0041689) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2016-03-04 |