| NPI | 1538651385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A201353) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 299765) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2026-06-22 |