| NPI | 1811359003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ND 20321) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301112111) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-01-29 |