| NPI | 1578821484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PR 19043) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI MD16208) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2018-06-21 |