| NPI | 1124057385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 47504) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 35900) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2021-04-22 |