| NPI | 1225607708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME174204) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2021022842) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-07-02 |