| NPI | 1184159238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 64493) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 227416) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2021-09-02 |