| NPI | 1770583320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD038745E) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: ME MD21694) |
| 207N00000X Dermatology (Licence: NY 1577481) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2019-12-12 |