| NPI | 1588628069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME82677) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: FL ME82677) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2023-09-11 |