| NPI | 1396745303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD182503) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN MD0000044278) |
| 207N00000X Dermatology (Licence: AZ 65971) | |
| 207N00000X Dermatology (Licence: WA MD60668630) | |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2024-06-25 |