| NPI | 1124123138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX H2172) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX H2172) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2015-08-25 |