| NPI | 1699905372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N4119) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301100206) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2014-10-22 |