| NPI | 1801139068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A150150) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 64429) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2021-12-17 |