| NPI | 1811358633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 22957) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS15495) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2024-07-24 |