| NPI | 1285891168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD153328) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: WA MD60215670) |
| 207N00000X Dermatology (Licence: WA MD60215670) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: OR MD153328) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-10-01 |