| NPI | 1972950285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 33793) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03604) |
| 208D00000X General Practice (Licence: FL ME133359) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2018-06-14 |