| NPI | 1366459026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MS 18070) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A63958) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2021-10-13 |