| NPI | 1447312384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 60450667) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A70271) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-03-04 |