| NPI | 1528598760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2022012789) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX T0252) |
| 207R00000X Internal Medicine (Licence: MA 271107) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-09-06 |