| NPI | 1912191461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 120088) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD442702) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2013-01-10 |