| NPI | 1265878789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OK 6265) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MO 2016034327) |
| 207N00000X Dermatology (Licence: TX R3974) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2020-03-18 |