| NPI | 1528454014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MT 76052) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2025-03904) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2025-12-08 |