| NPI | 1134507692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 278172) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME141336) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2022-04-08 |