| NPI | 1124210828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SD 8292) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NE 24277) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2015-03-09 |