| NPI | 1427379874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NM MD2014-0163) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 57429-20) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2014-11-04 |