| NPI | 1396136057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61271411) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 312722) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2022-08-16 |