| NPI | 1922791656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2025025943) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX V2796) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2025-07-17 |