| NPI | 1952461329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G49465) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA G49465) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G49465) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2013-12-30 |