| NPI | 1871901918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 293128) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5101021933) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2021-02-11 |