| NPI | 1598743601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME147373) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NH 12841) |
| 207N00000X Dermatology (Licence: MN 45708) | |
| 207N00000X Dermatology (Licence: MA 236945) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2021-02-17 |