| NPI | 1396065769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX T5629) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TN MD0000051717) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX T5629) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TN MD0000051717) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX 207NS0135X) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TN MD000051717) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2022-04-25 |