| NPI | 1154771954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61154814) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2016016958) |
| 207R00000X Internal Medicine (Licence: MO 2016016958) | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-10-10 |