| NPI | 1548260995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NM MD 2004-0502) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A65180) |
| 207N00000X Dermatology (Licence: IL 036-094530) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2019-06-18 |