| NPI | 1578896247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A82036) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A82036) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2020-08-04 |