| NPI | 1770575029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 052057) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 052057) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: GA 052057) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2024-03-05 |