| NPI | 1790759348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101244894) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 01001244894) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2017-01-13 |