| NPI | 1144684614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 63862) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 300558) |
| 207N00000X Dermatology (Licence: TX T4946) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-09-15 |