| NPI | 1114122512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX N7991) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: TX N7991) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2011-09-27 |