| NPI | 1699396796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME167944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT219790) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2025-11-19 |