| NPI | 1821060781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 058402) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD425726) |
| 207N00000X Dermatology (Licence: NV 15031) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2023-01-02 |