| NPI | 1750585741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 60869820) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101244008) |
| 207N00000X Dermatology (Licence: NE 25916) | |
| 208D00000X General Practice (Licence: MS 21809) | |
| 208D00000X General Practice (Licence: NE 25916) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-05-04 |