| NPI | 1457514424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME107335) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 60 241811) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2011-10-04 |