| NPI | 1982139184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MS 28288) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MS T-3411) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2021-06-16 |