| NPI | 1619139615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 30848) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2012-00008) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-09-08 |