| NPI | 1003003153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60421884) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA ML20009098) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2018-06-01 |