| NPI | 1932375474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60201749) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 049378) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2021-04-26 |