| NPI | 1144365495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 84441) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD60646305) |
| 208D00000X General Practice (Licence: NE 23814) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2021-07-15 |