| NPI | 1578776571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX PA02134) | 
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: TX PA02134) | 
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX PA02134) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX PA02134) | |
| Enumeration Date | 2007-05-07 | 
| Last Update Date | 2008-01-02 |