| NPI | 1104245505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R6564) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX R6564) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2020-07-08 |