| NPI | 1558676668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 0053513) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL UO2444) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2021-02-09 |