| NPI | 1891012969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A126346) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IA R-8810) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2021-12-10 |