| NPI | 1982638961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME 95646) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 223450) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2025-03-17 |