| NPI | 1235573114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MT 56288) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 49545) |
| 207N00000X Dermatology (Licence: AZ R73761) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2019-03-27 |