| NPI | 1750327417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 54548) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 110227) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2019-08-19 |