| NPI | 1750601696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 31207) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 054292) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-02-01 |