| NPI | 1154765667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: FL ME145594) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME145594) |
| 207R00000X Internal Medicine (Licence: FL ME145594) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2021-08-03 |