| NPI | 1225131865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00021891) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: WA MD00021891) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: WA MD00021891) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2010-06-28 |