| NPI | 1225457880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NH 19507) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NH LT-4069) |
| 207N00000X Dermatology (Licence: MA 274931) | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2021-04-06 |