| NPI | 1154422327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME100726) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25ma08145400) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-09-29 |