| NPI | 1710340757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 73187) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 62831) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2021-02-03 |