| NPI | 1023178092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61239203) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.137367) |
| 207N00000X Dermatology (Licence: NJ 25MA08624400) | |
| 207N00000X Dermatology (Licence: NY 259770) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-02-09 |