| NPI | 1245221712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 34511) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101244905) |
| 207N00000X Dermatology (Licence: CO DR-38037) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2025-09-29 |