| NPI | 1700272978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 52223) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 65477) |
| 207N00000X Dermatology (Licence: SC 84039) | |
| 207ND0900X Dermatology Dermatopathology (Licence: MN 65477) | |
| 207ND0900X Dermatology Dermatopathology (Licence: SC 84039) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2021-06-01 |