| NPI | 1821178716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G48767) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MT 141253) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2024-04-18 |