| NPI | 1255322319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR0054452) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A36171) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2020-03-01 |