| NPI | 1285614701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME124666) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 40652) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-08-28 |