| NPI | 1558823823 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME150603) | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL TRN28028) | 
| 207R00000X Internal Medicine (Licence: FL TRN28028) | |
| Enumeration Date | 2019-04-04 | 
| Last Update Date | 2023-01-16 |