| NPI | 1356599047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 271690-1) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX P3232) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2023-07-13 |