| NPI | 1548596083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL 9210033) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL 9210033) |
| Enumeration Date | 2009-10-18 |
| Last Update Date | 2022-05-18 |