| NPI | 1366412033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 15514) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC NC9901324) |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: NC NC9901324) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: SC 15514) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2018-02-02 |