| NPI | 1902164551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 58655) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: CO 58655) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2022-10-21 |