| NPI | 1679783567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN DO2262) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 4371) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-04-17 |