| NPI | 1295819043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME141617) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 191193-0) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-12-02 |