| NPI | 1417016544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A55676) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME71253) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2021-12-02 |