| NPI | 1538505847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 38269) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: ID M-13903) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2021-12-01 |