| NPI | 1871814095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301106750) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 261792) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2020-03-20 |