| NPI | 1104557917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: NE 10675) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2023020670) |
| 207R00000X Internal Medicine (Licence: MO 2022023046) | |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2026-06-24 |