| NPI | 1245228063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX K3186) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME145919) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2025-07-30 |