| NPI | 1386263440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A204289)  | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301512697)  | 
| Enumeration Date | 2020-04-09 | 
| Last Update Date | 2025-08-11 |