| NPI | 1225491616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61447491) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101263003) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-10-01 |