| NPI | 1548571821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME151841) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301097012) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2023-03-07 |