| NPI | 1669462610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: GA 051166) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A62702) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: KY 38362) | |
| 207N00000X Dermatology (Licence: GA 051166) | |
| 207N00000X Dermatology (Licence: CA A62702) | |
| 207N00000X Dermatology (Licence: KY 38362) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2007-07-09 |