| NPI | 1487114047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A185740) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 67953) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-06-27 |