| NPI | 1770837189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME124603) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL TRN19154) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2018-11-30 |