| NPI | 1659691772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX M2384) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A124332) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2022-07-26 |