| NPI | 1841223583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 66579) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A76259) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: ND 12210) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-01-31 |