| NPI | 1063482214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: KY 40176) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 44924) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2022-05-17 |