| NPI | 1740573625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2014-01016) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: NC 2014-01016) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NC 2014-01016) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2019-12-16 |