| NPI | 1225391543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R2017) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2012018188) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-21 |