| NPI | 1922206580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 53005) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 262140) |
| 207N00000X Dermatology (Licence: MI 4301038363) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2013-03-05 |