| NPI | 1326433897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD.61131369) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME140151) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-01-18 |