| NPI | 1598939464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101252185) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2010-00630) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2012-09-12 |