| NPI | 1851549695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL me110325) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX M9116) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2020-01-27 |