| NPI | 1700856721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101239588) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY 39318) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2007-07-08 |