| NPI | 1538429055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 83734) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA OS018067) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2022-12-06 |