| NPI | 1063755718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 65608) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MD D86094) |
| 207N00000X Dermatology (Licence: FL ME144533) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-11-09 |