| NPI | 1154347847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME99968) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35085133) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2014-08-13 |