| NPI | 1063689727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 54704-20) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VT 042.0015116) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2021-09-27 |