| NPI | 1902500622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 77534) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 33383) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2026-04-01 |