| NPI | 1134531221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX S3338) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD464686) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD464686) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2019-12-23 |