| NPI | 1609260538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301109128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066290) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2016-07-05 |