| NPI | 1720031396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME79593) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 212720) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME79593) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-07-21 |