| NPI | 1962851345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 286091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267425) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2021-04-05 |