| NPI | 1225272461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME113520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME113520) |
| 207Q00000X Family Medicine (Licence: TX P3434) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2018-06-11 |