| NPI | 1679557144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA BA9592014) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 34468) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2022-05-18 |