| NPI | 1366634206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: DC MD039055) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D77053) | 
| Enumeration Date | 2007-08-14 | 
| Last Update Date | 2018-01-04 |