| NPI | 1407841349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301070644) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35064980R) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2010-01-20 |