| NPI | 1154405140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A72977) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 245781) |
| 207N00000X Dermatology (Licence: HI 14139) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-12-03 |