| NPI | 1063155505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 74533) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 293975) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2023-06-29 |