| NPI | 1356490163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 239990) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA pending) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2016-07-27 |