| NPI | 1366418931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A101945) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 224015) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2021-04-05 |