| NPI | 1598963498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 235796) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT184158) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2008-08-28 |