| NPI | 1013276237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID M16146) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MT 70591) |
| 207R00000X Internal Medicine (Licence: TX BP10044142) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2021-12-03 |