| NPI | 1245853761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX U4754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10071295) |
| 207Q00000X Family Medicine (Licence: TX U4754) | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2025-10-09 |