| NPI | 1497754295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA 24610) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA 4301044740) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2007-07-08 |