| NPI | 1134165830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2006-00799) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0102201026) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-10-02 |