| NPI | 1891960696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 67815) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 141562) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2015-03-19 |