| NPI | 1285808691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA a117344) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 57.008390) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2018-05-14 |