| NPI | 1316328719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 71763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066220) |
| 281P00000X Chronic Disease Hospital | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-06-16 |