| NPI | 1760676910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OR MD28106) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA MD60010352) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2011-01-03 |