| NPI | 1164688230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A 104719) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: UT 5216196-1205) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2012-04-18 |