| NPI | 1679796429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NP0225X Dermatology Pediatric Dermatology (Licence: MN 57824) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: MA 241976) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-11-14 |