| NPI | 1548216724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: SD 5902) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2003008581) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2008-05-08 |