| NPI | 1790928919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX P2785) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME127088) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2020-02-19 |