| NPI | 1578778445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 069222) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AL 27568) |
| 207N00000X Dermatology (Licence: MI 4301084162) | |
| 207N00000X Dermatology (Licence: KY 43292) | |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2013-03-28 |