| NPI | 1619064110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: UT 49298911205) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: UT 49298911205) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: UT 49298911205) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-11-18 |