| NPI | 1295029361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 49691) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME123433) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2018-08-30 |