| NPI | 1578535662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD150954) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35073120) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2012-07-03 |