| NPI | 1609083203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX K3905) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: TX K3905) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX K3905) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX K3905) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2015-08-12 |