| NPI | 1578597423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX H1533) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX H1533) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-02-16 |