| NPI | 1477818938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 20A13001) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL UO3194) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-04-23 |