| NPI | 1215370630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: WA MD60676910) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD60676910) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2019-05-03 |