| NPI | 1629097142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX M4086) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 43245) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-02-08 |