| NPI | 1275714545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N3038) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A140309) |
| 207N00000X Dermatology (Licence: SC 35495) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2022-09-22 |