NPI | 1376030015 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA12366700) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T9979) |
Enumeration Date | 2018-04-18 |
Last Update Date | 2025-01-16 |