| NPI | 1215199963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 106410) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 42182) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2012-08-21 |