| NPI | 1053801001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME170552) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 318278) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2024-12-17 |