| NPI | 1245473941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME112666) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA ML20008257) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2021-12-15 |