| NPI | 1205152790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Q3560) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: DC MD042245) |
| 207N00000X Dermatology (Licence: MD D78222) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2015-07-31 |