| NPI | 1902862303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 200500178) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200500178) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-01-24 |