| NPI | 1962820696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301502259) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5315064582) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2020-05-28 |