| NPI | 1174086292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 77645) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 1014022) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2024-09-30 |