| NPI | 1528250727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR FL2043711) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: OR MD150890) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2012-11-19 |