| NPI | 1770733446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A137775) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 250593) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2015-09-18 |