| NPI | 1215179502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60397502) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A123841) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2018-08-23 |