| NPI | 1619909611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CT 046274) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: MI 4301079716) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-02-16 |