| NPI | 1154857159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX V3545) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.141904) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-03-20 |