| NPI | 1760745012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 265686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251433) |
| 207N00000X Dermatology (Licence: MA 251433) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-03-03 |