| NPI | 1457615650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VT 042.0013526) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101321) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2016-09-07 |