| NPI | 1912976135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD465296) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 45630) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-08-28 |