| NPI | 1184502965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA LT000951) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: PA LT000951) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: PA LT000951) | |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: PA LT000951) | |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-27 |