| NPI | 1568705556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 31225) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2017-01521) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2020-08-11 |