| NPI | 1053765784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD471465) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT212137) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2021-02-11 |