| NPI | 1154421485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME132842) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 224157-1) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2018-03-17 |