| NPI | 1770684219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA a89344) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME87453) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |