| NPI | 1568807238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 58337) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL UO3718) |
| 207R00000X Internal Medicine (Licence: AZ R2235) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2020-11-20 |