| NPI | 1619058542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A111384) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA MD.025872) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2014-04-03 |