| NPI | 1720246614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 43415) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT190084) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2021-03-17 |