| NPI | 1386960847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A141215) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 117991) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2019-01-23 |