| NPI | 1104020767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N3580) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX BP1-0022965) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2010-01-28 |