| NPI | 1073001640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A163673) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD479141) |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2024-09-05 |