| NPI | 1760456529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G42697) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G42697) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2021-02-01 |