| NPI | 1902398779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 76583) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH PEND) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-04-30 |