| NPI | 1255434742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME134621) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101283661) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME134621) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MD 13244) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2024-10-04 |