| NPI | 1255866745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 192547) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 311771) |
| Enumeration Date | 2017-04-22 |
| Last Update Date | 2024-08-01 |