| NPI | 1083614986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G87780) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 147173) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2007-07-13 |