| NPI | 1730455320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME 127981) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AL 496564) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2025-05-12 |