| NPI | 1528172319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL me91432) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME91432) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-03-15 |