| NPI | 1053845594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 92202) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AL 37744) |
| 208D00000X General Practice (Licence: AL 37744) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2025-06-26 |