| NPI | 1962744730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA 308643) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301106872) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2018-12-04 |