| NPI | 1659635845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 59017) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX BP10041061) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2016-02-11 |