| NPI | 1255524336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD442765) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT190167) |
| 207N00000X Dermatology (Licence: DE C1-0009785) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2011-11-17 |