| NPI | 1700964780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV 13132) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 230915) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-08-09 |