| NPI | 1699947317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A111232) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD036840) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2012-05-16 |