| NPI | 1982136321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 72304) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A173490) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2022-10-10 |