| NPI | 1912908393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 38326) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CT 038326) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2024-07-11 |