| NPI | 1578140554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 181448) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 081712) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-06-12 |