| NPI | 1902165012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 269982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201159) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2017-06-30 |