| NPI | 1245525393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD467432) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD200001398) | 
| 207N00000X Dermatology (Licence: MD D0091888) | |
| Enumeration Date | 2011-06-16 | 
| Last Update Date | 2023-04-21 |