| NPI | 1558532630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX P4311) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 256373) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2024-12-16 |