| NPI | 1841275377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NP0225X Dermatology, Pediatric Dermatology (Licence: MN 31241) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: WI 33053) |
| 208000000X Pediatrics (Licence: MN 31241) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-05-03 |