| NPI | 1881777316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00049001) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A123412) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2013-01-08 |