| NPI | 1053706960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 274081) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 274081) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2023-09-11 |