| NPI | 1639387095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME106953) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35089547) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2015-07-02 |