| NPI | 1578532271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WV 20440) |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 20440) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2014-01-21 |