| NPI | 1184985996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME134338) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX Q5615) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2018-03-17 |