| NPI | 1568882082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX R3534) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX BP10050055) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2021-09-30 |