| NPI | 1902171341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME146921) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A146889) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2022-12-21 |