| NPI | 1649536095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA 206232) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101260143) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2019-10-29 |