| NPI | 1801242292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: DC MD210001378) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN 60585) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2021-08-10 |