| NPI | 1568544914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 035147) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G85769) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2010-08-05 |