| NPI | 1619192788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME100603) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI LP00297) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2010-08-19 |