| NPI | 1386645752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K8209) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX 0101056185) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: TX 0101056185) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX 0101056185) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX 0101056185) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2007-12-28 |