| NPI | 1790797454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA 018341) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MS 13029) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2011-08-11 |