| NPI | 1376127043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 336476) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5315225062) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2025-06-09 |