| NPI | 1710007026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 177895) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.097237) |
| 207N00000X Dermatology (Licence: NH LT4235) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: OH 35.097237) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-12-09 |