| NPI | 1073776613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A115309) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX N1306) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-12-22 |