| NPI | 1942681655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 007839) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5101022011) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2019-08-02 |