| NPI | 1962726489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35120393) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 261572) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2015-03-04 |