| NPI | 1437685385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME150253) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 332058) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-03-19 |