| NPI | 1215383740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 074264) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT214475) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2023-07-11 |