| NPI | 1770088379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 04-46364) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2022015150) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2022-07-19 |