| NPI | 1669822219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 271343) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT210961) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2017-10-30 |