| NPI | 1649329533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D45564) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: MD D45564) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-11-28 |