| NPI | 1639232952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N7679) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G18677) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2012-04-18 |