| NPI | 1316267578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD455630) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 123895) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2017-05-12 |