| NPI | 1356753743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA OP60852010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3992) |
| 207N00000X Dermatology (Licence: CA 20A14301) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2020-12-10 |