| NPI | 1053731927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NM MD2020-1069) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX R7559) |
| 207N00000X Dermatology (Licence: DC MTL002961) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2025-11-04 |