| NPI | 1134556400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME134257) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.127065) |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: OH 35.127065) | |
| 208000000X Pediatrics (Licence: OH 35.127065) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2018-10-15 |