| NPI | 1972716157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00018339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00018339) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-09 |