| NPI | 1659593481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD14554) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD00034712) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |