| NPI | 1710476932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 84191) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OR MD207164) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2026-03-25 |