| NPI | 1265960264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T2309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271586) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2021-08-12 |