| NPI | 1780950352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0438483) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 0438483) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2020-10-13 |