| NPI | 1720422033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101270055) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D0085488) |
| 207N00000X Dermatology (Licence: DC MD046070) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2020-08-21 |