| NPI | 1023128774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101248492) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 46085) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-02-12 |