| NPI | 1962409300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PR 8787) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 80172) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2024-12-16 |