| NPI | 1215044649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 47850) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NE 21130) |
| 207N00000X Dermatology (Licence: IA 30365) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2010-07-01 |