| NPI | 1982692240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: MA 78854) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 78854) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: MA 78854) | |
| 207R00000X Internal Medicine (Licence: MA 78854) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2021-01-08 |