| NPI | 1245556604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 39318) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 280348) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2021-12-14 |