| NPI | 1073762803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 49877) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CO 2979) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2021-04-08 |