| NPI | 1467427930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 200000627) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY 23102) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2019-12-31 |