| NPI | 1447393251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS9945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS9945) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2012-02-16 |