| NPI | 1689802696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME138881) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 62177) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2020-09-01 |