| NPI | 1336192624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WV 21773) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD428812) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2015-01-23 |