| NPI | 1255377958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 530781) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2004016560) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2017-08-08 |