| NPI | 1407122674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 286880) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX T9451) |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2022-12-09 |