| NPI | 1396790317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2018-02899) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS13448) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MI 5101012868) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2018-12-04 |