| NPI | 1306053707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35093057) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301088164) |
| 207ND0900X Dermatology, Dermatopathology (Licence: MI 4301088164) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2017-06-08 |