| NPI | 1871567578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: KY 54389) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: SC 26593) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-09-21 |