| NPI | 1457779589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D85174) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 262737) |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2018-11-01 |