| NPI | 1316163157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME97403) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A100908) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-01-24 |