| NPI | 1912999558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 184054) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 48384) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2023-03-10 |