| NPI | 1932382512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 44247) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A94594) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2019-09-13 |