| NPI | 1487696605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 200900259) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME95232) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-02-24 |