| NPI | 1114931763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 95790) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME96265) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-01-27 |