| NPI | 1255070629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2026009543) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL NA) |
| 207R00000X Internal Medicine (Licence: IL 125.080232) | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2026-06-12 |