| NPI | 1558361345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MS 16501) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 25961) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2014-06-30 |