| NPI | 1255303632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA OP 60212402) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0102201216) |
| 207N00000X Dermatology (Licence: AK 6867) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2012-05-22 |