| NPI | 1376528356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WV 16077) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: SC 21723) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2012-01-11 |