| NPI | 1750561056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA C138472) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D72167) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2021-08-25 |