| NPI | 1790805729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME118722) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5315026470) |
| 207N00000X Dermatology (Licence: AZ 42968) | |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2023-01-24 |