| NPI | 1548777683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA KK37596) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA KK307596) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-06-16 |