| NPI | 1326009473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 044520) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 189168) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2008-06-30 |