| NPI | 1124012992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301066888) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: MI 4301066888) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2014-01-22 |