| NPI | 1457765968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS14644) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5101021452) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: FL OS14644) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2018-11-20 |