| NPI | 1528050804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 045800) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 045800) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-01-10 |