| NPI | 1417274812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 75265) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA10674800) |
| 207N00000X Dermatology (Licence: VA 0101254559) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2024-10-31 |