| NPI | 1730192204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2015-02139) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL me103760) |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL ME 103760) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: NC 2015-02139) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2021-03-04 |