| NPI | 1619324746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PR 19747) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19747) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2021-07-15 |