| NPI | 1649712761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL MFC1784) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: ZZ 5163604) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2017-04-17 |