| NPI | 1972697456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00026387) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00026387) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-08-19 |