| NPI | 1245223023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ND 5817) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 33100) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2011-08-25 |