| NPI | 1457663064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 53264) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 105067) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2011-11-02 |