| NPI | 1982165965 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME162452)  | 
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL 162452)  | 
| Enumeration Date | 2019-03-31 | 
| Last Update Date | 2025-05-05 |