| NPI | 1891113395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A156877) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 294043) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2025-01-20 |