| NPI | 1699092866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Q4346) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 269220) |
| 207N00000X Dermatology (Licence: MA 258445) | |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2023-08-10 |