| NPI | 1649833328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ND 22280) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 10809) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-09-24 |