| NPI | 1962494294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: MS 1731) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: LA 024878) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2022-12-12 |