| NPI | 1518124759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME 111689) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 238027) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2013-10-22 |