| NPI | 1770089161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 66401) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 29762) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2020-08-24 |