| NPI | 1770742249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101243049) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D0067082) |
| 207N00000X Dermatology (Licence: DC MD035113) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2011-09-27 |