| NPI | 1891819801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301083995) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A93479) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2012-02-16 |