| NPI | 1306920830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: VA 0101261562) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 200101474) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2017-04-28 |