| NPI | 1306296157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 1018073) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA10901700) |
| 207N00000X Dermatology (Licence: CA A179271) | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-03-14 |