| NPI | 1356532543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA MD.208214) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N0249) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-11-16 |