| NPI | 1184065690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T2393) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 57.022408) |
| 207N00000X Dermatology (Licence: KY 49120) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2023-12-20 |