| NPI | 1679917116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60931788) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A150816) |
| 207N00000X Dermatology (Licence: OH 35.127603) | |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2019-04-24 |