| NPI | 1972594893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35.133591) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A84038) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2018-08-09 |