| NPI | 1083141535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 55065) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT213338) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2021-07-06 |