| NPI | 1831267459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 22850) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 22850) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2009-06-08 |