| NPI | 1801279948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 20A17098) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL UO4611) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2019-07-12 |