| NPI | 1366738874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61231855) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2015026116) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2024-10-15 |