| NPI | 1891149993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME145243) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 218781) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2023-03-20 |