| NPI | 1962448522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A117202) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A117202) |
| 207N00000X Dermatology (Licence: WI 51427-20) | |
| 207R00000X Internal Medicine (Licence: WI 51427-20) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2011-07-27 |