| NPI | 1306130539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60981346) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0438934) |
| 208000000X Pediatrics (Licence: PA MD450812) | |
| 208000000X Pediatrics (Licence: MO 2016011749) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2023-08-07 |