| NPI | 1184999260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60491657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60491657) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2018-11-16 |