| NPI | 1578560132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 017267) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CT 017267) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: CT 017267) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CT 017267) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2007-07-08 |