| NPI | 1194764837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60117060) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 238443) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2018-03-17 |