| NPI | 1972267359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: OK 205679) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 205679) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2021-10-22 |