| NPI | 1124695671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IA AI-4033089-2127) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301515096) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2025-07-30 |