| NPI | 1821315557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME150042) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 269204) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2021-11-12 |