| NPI | 1871686980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME143477) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD465974) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-01-31 |