| NPI | 1124344825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 54364) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 105568) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2015-07-23 |