| NPI | 1528057940 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 9703) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 159006) | 
| Enumeration Date | 2005-10-18 | 
| Last Update Date | 2020-08-03 |