| NPI | 1023128758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301108760) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 200300521) |
| 207L00000X Anesthesiology (Licence: MI 4301108760) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-03-15 |