| NPI | 1477874311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA OP60675086) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: WA OP60675086) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-10-17 |