| NPI | 1780248948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 323324) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WI 76033-20) |
| 207N00000X Dermatology (Licence: TX U6325) | |
| 207N00000X Dermatology (Licence: IL 036.165112) | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2024-11-14 |