| NPI | 1407112212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A150443) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD457359) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2019-06-04 |