| NPI | 1750500955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD431451) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD431451) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |