| NPI | 1063510675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ME 015408) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NH 10992) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-05-16 |