| NPI | 1508277468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R4193) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 274611) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2021-04-13 |