| NPI | 1508199431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A125110) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A125110) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2021-10-15 |