| NPI | 1679550974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO MO2010018432) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 47025) |
| 207N00000X Dermatology (Licence: AZ 36196) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2015-03-03 |