| NPI | 1942359799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD60788108) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2014-02298) |
| 207N00000X Dermatology (Licence: MA 229815) | |
| 207N00000X Dermatology (Licence: FL ME111829) | |
| 207N00000X Dermatology (Licence: VA 0101254768) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-05-18 |