| NPI | 1902196264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 60616527) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NM MD2015-0857) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2016-01-20 |