| NPI | 1407198690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 282659) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 302310) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2020-07-02 |