| NPI | 1457889909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 78388) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 286727) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2025-03-15 |