| NPI | 1962480970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA 28400) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: IA 28400) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2022-06-30 |