| NPI | 1811973951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101235150) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101235150) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2016-02-15 |