| NPI | 1619260122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV 2157) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 20A14883) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2020-02-10 |