| NPI | 1326173154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 250248) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 19768) |
| 207N00000X Dermatology (Licence: GA 062910) | |
| 207N00000X Dermatology (Licence: CA A 105466) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2021-02-19 |