| NPI | 1477514834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101042830) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: VA 0101042830) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2015-01-21 |