| NPI | 1750386462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 021687) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME132882) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2022-09-29 |