| NPI | 1942628839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 30610) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 65959 - 20) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2018-07-20 |