| NPI | 1740638949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 64088) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5315086501) |
| 208D00000X General Practice (Licence: FL UO 4912) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-06-21 |