| NPI | 1508831900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ME 017218) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2005-00586) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: NC 2005-00586) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NC 2005-00586) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2011-06-22 |