| NPI | 1457841405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 74881) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 66951) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2025-09-11 |