| NPI | 1528179108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME105938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101226754) |
| 207Q00000X Family Medicine (Licence: FL ME 105938) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-02-21 |