| NPI | 1407533995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA 95026633) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95026633) |
| 208000000X Pediatrics (Licence: CA 95026633) | |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-08-23 |