| NPI | 1619046026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WI 48358) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX M8812) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX M8812) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-10-03 |