| NPI | 1376739268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A96417) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 245761) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2012-02-08 |