| NPI | 1366836629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD61397783) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 297822) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2024-01-31 |