| NPI | 1588955454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 68625) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A125794) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2021-03-12 |