| NPI | 1962908871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 65932) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 165620) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2022-08-02 |