| NPI | 1588220776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 327108) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.149335) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2024-05-01 |